Transferring Life

Thank you all so much for your prayers! No really, thank you! Saturday was one of the darkest days of my life. It was actually worse than you may imagine initially because the phone call from my doctor was confusing. I don't blame him as I was sobbing and may have been hard to understand, but he said that the embryos should have been 8 cells on day 2... which is incorrect, but for the next three hours I was certain that they would all die. Sam eventually looked it up online and showed me that no, they should be 4 cells which meant that most of ours were behind, but not that behind. I called and confirmed it with a nurse, but still felt really unsure about their ability to even survive the night. The doctor had called them fragile, and there was no arguing that most were a half to a whole day behind in there expected growth. It was such a long day and long night!

But someone somewhere has a special seat up front in the Throne Room, or maybe it was the collective cry of so many. I can't explain it, but those embryos "perked right up" overnight, as my doctor said. I'm still confused on the numbers and how this happened, but we have eight embryos. He said there were seven on Saturday and eight on Sunday. In addition to that, half of them were on pace or ahead. We had two 8 cell, one 9 cell, and one 12 cell on day three when they should be 8 cells. Now nothing had a perfect grade, but most had a grade of 2 meaning a little fragmentation but all the cells are equal. I'm not sure I can adequately describe the change in their outlook from day 2 to day 3... even our doctor was really impressed!

Despite the change, he still recommended that we go ahead with a day 3 transfer. And after chatting with Dr. Duffy, I'm much more okay with this. He admitted that he is probably the only doctor in the clinic who would recommend this... everyone else in the practice likes to push for day 5 blastocysts. And I was suddenly reminded why I chose him, why I like him. He is for giving each of my embryos the best chance at life, not pushing them to survive in a lab with manmade medium so that only the fittest survive. He said pushing for day 5 may only leave me with one or two blasts, or none, and there's absolutely no proof that an embryo that perishes in the lab between day 3 and day 5 wouldn't have survived and grown into a beautiful baby if transferred earlier. I know a lot of people disagree with this, but that's okay. We just want to give them all a chance. It probably means that future FETs (frozen embryo transfers) will fail at a higher rate, but our embryos fought really hard to get to day 3... we're not giving up on them just because they had a rocky start.

We ended up transferring two embryos, an 8 cell grade 2 and the 12 cell grade 2. He did still offer to transfer three and explained that this would be against ASRM's Transfer Guidelines, but that if our absolute goal is a pregnancy from this cycle, that's what he'd recommend. Essentially, day 3 embryos are just harder to judge.... the ones that would have died in between day 3 and day 5 in the lab might very well die in the uterus... there's no good way to know, which is why a day 5 transfer is typically preferred. I will say that FIRM is a little flippant with the embryo transfer guidelines... Nazis about OHSS, but not so much on how many should be transferred. They of course have a slightly higher twin rate because of that. We decided to stick with two. These are my reasons:

1. My goal is not to get pregnant no matter what out of this cycle. My goal is to get pregnant. If it's not this cycle than hopefully next.
2. I'm still not super comfortable with the Lupron trigger, I feel better about it, but not great. Therefore, putting all of me eggs embryos in one basket uterus, doesn't make me very comfortable.
3. We want a safe pregnancy for me and the baby (or babies). There is undeniably an increased risk for each additional baby.
4. We don't want triplets. Twins is one thing, but triplets? Not really in our plans. The odds of all three implanting as day 3 embryos was crazy small, but I don't gamble. And I also would feel super weird hoping that one or two dies during the next two weeks... super weird.

The transfer went really smoothly. Dr. Duffy said I was the best transfer of the day. The one thing I've got going for me in the reproductive department is a normal uterus and an easily accessible cervix. It really felt no different than an IUI in terms of procedure (other than the painfully full bladder)... there was the HUGE difference though in the fact that they weren't injecting several million sperm but rather transferring 2 precious embryos. There are a couple of things that I really hated about the transfer though, most notably was that Sam couldn't be in the room. I had never heard of a clinic that didn't allow the spouse to be in the transfer room. It's a really special moment and I hate that Sam missed it. The second thing I hate is that they didn't give me a picture of my embryos... I thought that was standard. I did however get an ultrasound image of them at the moment of transfer. 

The embryo in in the little glowing blob. I'm not sure why it glows, but I
assure you, the embryos are not radioactive. : )

It was so weird. I went into the transfer a sad, depressed, mopey mess... even with the news about the improved quality I was feeling bummed that our IVF journey did not turn out as we had hoped. And then they transferred those embryos inside, the tears started to flow and my whole mindset changed. I'm not giving up on these embryos. I was reminded that these are the exact embryos that I was fighting for with all of those doctors... I said I didn't want just grade A and grade 1. I wanted them all because they all have a chance at growing into a take home baby. Well, I've got them. They're not perfect, but they're ours. They are genetically ours and now, more importantly, physically ours and we so desperately want them!

And that was it. My clinic strongly discourages bed rest. In fact, they don't even allow you to rest after the transfer. They get you up immediately and send you to empty your bladder. They said that they used to require bed rest, but recent studies have shown that bed rest is not only not helpful, but can be hurtful. I'm on the fence about it, but my desire to come home won out. Sam couldn't get off of work for an extra day and I was kind of an emotional mess after the roller coaster of Saturday and Sunday... I just wanted to be home with my husband and my sweet Sterling and Everest. As it was a day 3 transfer and nothing can implant for several days, I decided to come home yesterday after the transfer. It was a long drive and the entire time I was second guessing the wisdom, particularly with every bump in the road, but I'm trying to trust that they are snuggled in my uterus and hopefully were uninterrupted in their task of cell division by the bumpy roads. I decided to take today though and stay home as I'm still exhausted and sadly still recovering from the retrieval. We won't call it bed rest as I'm fixing my own food and beverage and doing some laundry, we will just call it being lazy and recuperating from a very long three weeks! 

So thank you again for all of your words of encouragement: your text messages, comments, and emails meant the world to us during one of our darkest days. And thank you for your prayers! The Lord decided to breathe life and we are so, so thankful!

Now settle in... eleven days and counting until the pregnancy test!